of urinary tract infections following flexible cystoscopy 灵活的膀胱镜检查后泌尿道感染的发病率课件

Omer Baldo, Hassan Khan, Philip Koenig, Nick Shaikh Department of Urology Airedale General Hospital. Increasing incidence of global antimicrobial resistance Urology as a speciality by its nature uses antibiotics with some liberty The annual European Antibiotic Awareness Day (EAAD) campaign in England this year will highlight the need to Start Smart-Then Focus The aim is that patients receiving antibiotics should receive the right drug at the right time at the right dose for the right duration Flexible cystoscopy is the commonest intervention performed by Urologists Local issue with high rate of pseudomonas UTI On going debate about the use of antibiotics prior to cystoscopy 1. Neal D et al BJUI 2007 Oct;100 (4) 826-9 Prospective audit at single Unit Over 26 months Jan. 2009 to Mar. 2011 In collaboration with Microbiology unit 2 urine samples collected Immediately pre procedure 3 days post procedure 1089 patients included Mean age 67.9yrs ( 16) Total samples collected 1811 367 post cystoscopy samples NOT submitted Overall rate of UTI 8.5 % Rate of UTI pre cystoscopy 6.2% Incidence of UTI excluding missing samples 10.2% Authors Journal No. Rate of UTIAuthors Journal No. Rate of UTI Neal et al BJUI 2007 2481 9% Burke et al BJUI 2002 420 2.7% Almallah et al Urology 2000 215 4.5% Clark et al BJUI 1990 164 7.5% UTI rate post outpatient cystoscopy is low Prophylactic antibiotics are unnecessary Prophylactic antibiotics should be used if approriate Beware of the margarine container